PurposeTo describe the features of a choroidal macrovessel (CM) in multimodal imaging and underline the importance of non‐invasive imaging techniques.MethodsA 78‐year‐old man presented to our department for alteration of central vision of the right eye after uneventful cataract surgery. The patient had a complete ophthalmic examination with best corrected visual acuity (BCVA) measurement and slit lamp examination. Multimodal imaging was performed including fundus autofluorescence (FAF), Swept‐Source Optical Coherence Tomography (SS‐OCT), en‐face OCT, OCT‐angiography, Fluorescein Angiography (FA) and Indocyanine Angiography (ICG‐A).ResultsBCVA was 20/50 in the right eye and 20/80 in the left eye. Anterior segment examination was unremarkable except for a nuclear cataract in the left eye. Funduscopic examination showed a subretinal tortuous lesion starting in the fovea and extending toward the temporal periphery in the right eye and was normal in the left eye. FAF of the right eye showed increased autofluorescence of the lesion retracing its serpiginous shape. SS‐OCT revealed a choroidal hollowness. This lesion had a pattern corresponding to a choroidal macrovessel on en‐face OCT scans with a similar signal to the physiological choroidal vessels. OCT‐A showed a low signal within the choroidal vessel. FA of the right eye showed an early serpentine‐shaped hyperfluorescence and ICG‐A revealed early prominent filling with late hypofluorescence and persisting laminar flow. A choroidal macrovessel (CM) was diagnosed.ConclusionsCM is a rare entity that is not always easy to recognize. ICGA is the most valuable tool for its diagnosis when the presentation is not typical. In cases of CM with a well delineated pattern, non‐invasive imaging modalities and particularly SS‐OCT and en‐face OCT can be very helpful for the diagnosis while avoiding dye injection.
Purpose: To discuss the causes and risk factors of uveal effusion after trabeculectomy and to describe the management of this complication. Methods: This observational retrospective case series included 5 consecutive cases of uveal effusion that developed after trabeculectomy with intraoperative 5‐FU. All patients underwent ophthalmological examination including best corrected visual acuity (BCVA) measurement, anterior segment and fundus examinations. Fundus photography, B‐scan ultrasonography and Swept Source optical coherence tomography (SS‐OCT) were used to detect and monitor choroidal detachment and hypotony maculopathy. Anterior segment optical coherence tomography (AS‐OCT) was performed to assess iridocorneal angle opening and anterior chamber depth. Results: Four men and one woman were included. Mean age was 48.8 ± 15.1 y. One patient had nanophtalmia confirmed by B‐scan ultrasonography while four patients had postoperative hypotonia caused by overfiltration (3 cases) and bleb leak (1 case). All patients received corticosteroids and cycloplegics associated with a reformation of the anterior chamber and in one case we performed bleb revision. We showed resolution of the choroidal effusion, normalization of the ocular hypertension and restoration of visual acuity in all cases. Conclusions: Uveal effusion after trabeculectomy occurs in 3%–34% of cases. Its management can be challenging and requires close monitoring. Conservative management can overcome choroidal detachment, restore visual acuity and avoid aggressive surgery. References. 1. Schrieber C, Liu Y. Choroidal effusions after glaucoma surgery. Current Opinion in Ophthalmology. 2015; 26(2): 134–42. 2. Senthikumar VA, Michra C. Ultra‐widefield image of choroidal detachment after combined glaucoma filtration surgery. Indian J Ophthalmol. 2020; 68(8): 1669.
Purpose: To evaluate postoperative changes and investigate tomographic prognostic factors of visual impairment after vitrectomy for epiretinal membrane (ERM). Methods: A retrospective observational study on patients who underwent pars plana vitrectomy for ERM by a single experimented surgeon. Best corrected visual acuity (BCVA) on the logMAR chart and optical coherence tomography (OCT) features were recorded before surgery and at the last visit. Tomographic parameters analysed were: central foveal thickness (CFT), foveal contour morphology, external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IZ) integrity, the presence of intraretinal fluid (IRF), subretinal fluid, disorganization of retinal inner layers (DRIL) and subfoveal deposits. Student's t‐test and Pearson's correlation coefficients were used for statistical analysis. p Values <0.05 were considered statistically significant. Results: Forty‐seven eyes of 43 patients were included. The mean age was 61.7 years (range 13–87). The ERM was idiopathic in 49% and secondary in 51%. The mean BCVA was 1.02 before and 0.5 after surgery and improved significantly (p < 0.001) with a mean gain of 5.2 lines. The postoperative BCVA correlated strongly with the preoperative one (R2 = 0,764, p < 0.001). Tomographic factors associated with worse final BCVA were higher baseline CFT (p = 0.004), abnormal foveal profile (p = 0.02), the presence of IRF (p < 0.001), DRIL (p = 0.01) and subfoveal deposits (p = 0.04). The disruption of ELM, EZ and IZ were as well associated with a poorer visual outcome (p < 0.001, p = 0.03 and p < 0.001 respectively). Conclusions: ERM surgery provides functional and anatomical improvement. Preoperative OCT is an essential tool to evaluate morphological retinal changes and identify prognostic factors for visual recovery.
Purpose: To describe the multimodal imaging findings in a case of chorioretinitis sclopetaria (CS). Methods: Single case report. Results: A 26‐year‐old male reported a history of ocular injury to the right eye (OD) in childhood caused by a palm tree branch after which he underwent cataract surgery. On examination, his best‐corrected visual acuity was light perception in OD. Anterior segment examination revealed the presence of an anterior chamber intraocular lens. Intraocular pressure was within the normal range. Dilated funduscopy showed an area of bare sclera in the inferonasal quadrant adjacent to a white fibroglial proliferation that extended to the nasal and temporal periphery consistent with CS. A large area of chorioretinal atrophy involving the macular region with a nasal demarcation line and scattered hyperpigmented patches was also noted. The left eye examination was unremarkable. Fundus autofluorescence showed hypoautofluorescence of the scar tissue and in the posterior pole. Swept‐source optical coherence tomography scans confirmed the rupture of the choroid underneath a full‐thickness hyperreflectivity in the inferonasal quadrant and revealed disruptions in the macular RPE and outer retinal layers. Conclusions: CS is caused by a shock wave from a high‐velocity projectile resulting in the tearing of the choroid, retinal pigment epithelium (RPE), and neurosensory retina which later induces fibrous scarring, RPE hyperplasia, and photoreceptor loss. Multimodal imaging findings of CS are consistent with these features.
Purpose: To study the effect of active cigarette smoking on retinal and choroidal micro‐vascularization using Swept Source Optical Coherence Tomography Angiography (SS‐OCT A). Methods: This is a cross‐sectional, observational, comparative study carried out at the Ophthalmology department of Habib Thameur University Hospital of Tunis. Twelve eyes of “healthy” smokers, 10 eyes of former smokers (less than 3 years after quitting smoking) and 6 eyes of healthy non‐smokers controls were included. SS‐OCT A 3 × 3 mm angiograms were exported and analysed with image J, Fiji Software. Perimeter of avascular central zone (ACZ), superficial retinal plexus density (SRPD), deep retinal plexus density (DRPC) and choriocapillaris capillary vessel density (CVD) were calculated and analysed. Comparative Kruskal Wallis and Spearman tests were performed using 21.0 SPSS. Results: Volunteers with a smoking history had an average of 13.75 ± 10.26 pack‐years. The mean smoking period was 3.2 ± 5.13 years and mean smoking cessation period was 1.28 ± 0.85 years. Mean ACZ, SRPD, DRPD and CVD were respectively 2.62 ± 0.52 mm, 13.20 ± 2.10%, 17.14 ± 1.17% and 51.05 ± 0.85%. There was no significant difference between the three groups for the measurements of ACZ, SRPD, DRPD and CVD (p = 0.57, p = 0.97, p = 0.53 and p = 0.07; respectively). However, there was a significant positive correlation between the smoking cessation period and the DRPD (p = 0.003, r = 0.865). Conclusions: Despite the known effects of nicotine and other chemical substances in cigarettes on peripheral vascular structures, no significant difference in quantitative analysis of retinal and choroidal networks could be found. Deep retinal plexus density seems to increase after long smoking cessation periods.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.